Yes, it is true, smoking does not cause lung cancer. It is only one of many risk factors for lung cancer. I initially was going to write an article on how the professional literature and publications misuse the language by saying "smoking causes lung cancer"1,2, but the more that I looked into how biased the literature, professional organizations, and the media are, I modified this article to one on trying to put the relationship between smoking and cancer into perspective. (No, I did not get paid off by the tobacco companies, or anything else like that.)

When the tobacco executives testified to Congress that they did not believe that smoking caused cancer, their answers were probably truthful and I agree with that statement. Now if they were asked if smoking increases the risk of getting lung cancer, then the answer based upon current evidence should be "yes." But even so, the risk of a smoker getting lung cancer is much less than anyone would suspect. Based upon what the media and anti-tobacco organizations say, one would think that if you smoke, you get lung cancer (a 100% correlation). You would at least expect a 50+% occurrence before someone used the word "cause."

Would you believe that the real number is < 10% (see Appendix A)? Yes, a US white male (USWM) cigarette smoker has an 8% lifetime chance of dying from lung cancer but the USWM nonsmoker also has a 1% chance of dying from lung cancer (see Appendix A). In fact, the data used is biased in the way they are collected and the actual risk for a smoker is probably less. I personally would not smoke cigarettes and take that risk, nor recommend cigarette smoking to others but the numbers were less than I had been led to believe. I only did the data on white males because they account for the largest number of lung cancers in the US, but a similar analysis can be done for other groups using the CDC data.

You don't see this type of information being reported, and we hear things like, "if you smoke you will die" but when we actually look at the data, lung cancer accounts for only 2% of the annual deaths worldwide and only 3% in the US.**

When we look at the data over a longer period of time, such as 50 years as we did here, the lifetime relative risk is only 8 (see Appendix A). That means that even using the biased data that is out there, a USWM smoker has only an 8x more risk of dying from lung cancer than a nonsmoker. It surprised me too because I had always heard numbers like 20-40 times more risk. Statistics that are understandable and make sense... it may be a new avenue of scientific inquiry.

The process of developing cancer is complex and multifactorial. It involves genetics, the immune system, cellular irritation, DNA alteration, dose and duration of exposure, and much more. Some of the known risk factors include genetics4,5,6, asbestos exposure7, sex8, HIV status9, vitamin deficiency10, diet11,12,13, pollution14 , shipbuilding15 and even just plain old being lazy.16 When some of these factors are combined they can have a synergistic effect17, but none of these risk factors are directly and independently responsible for "causing" lung cancer!

Take a look in any dictionary and you will find something like, "anything producing an effect or result."18 At what level of occurrence would you feel comfortable saying that X "causes" Y. For myself and most scientists, we would require Y to occur at least 50% of the time. Yet the media would have you believe that X causes Y when it actually occurs less than 10% of the time.

As ludicrous as that is, the medical and lay press is littered with such pabulum and gobbley-guk. Even as web literate physician, it took me over 50 hours of internet time to find enough raw data to write this article. I went through thousands of abstracts and numerous articles, to only find two articles that even questioned the degree of correlation between smoking and lung cancer (British lung cancer rates do not correlating to smoking rates)19,20 and another two articles which questioned the link between second hand smoke (passive smoking) and lung cancer.21,22 Everywhere I looked the information was hidden in terms like "odds ratio," "relative risk," or "annualized mortality rate," of which most doctors probably could not accurately define and interpret them all let along someone outside the medical profession. The public relies on the media to interpret this morass of data but instead they given politically correct and biased views.

If they would say that smoking increases the incidence of lung cancer or that smoking is a risk factor in the development of lung cancer, then I would agree. The purpose of this article is to emphasize the need for using language appropriately in the medical and scientific literature (the media as a whole may be a lost cause).

Everything in life has risk; just going to work each day has risk. Are we supposed to live our lives in bed, hiding under the blanket in case a tornado should come into our bedroom? We in science, have a duty to give the public accurate information and then let them decide for themselves what risk is appropriate. To do otherwise is to subtly impose our biases on the populace.

We must embrace Theoretics as a discipline as it strives to bring objectivity and logic back into science. Every article/study has some bias in it, the goal is to minimize such biases and present the facts in a comprehensible and logical manner. Unfortunately, most scientists have never taken a course in logic and I'm sure that English class was not their favorite. Theoretics is a field of science which focuses on the use of logic and appropriate language in order to develop scientifically credible theories and ideas which will then have experimental implications. As someone whom I respect says, "Words mean things." Let us use language and logic appropriately in our research and the way that we communicate information.

* * * * *

Yes, smoking is bad for you, but so are fast-food hamburgers, driving, and so on. We must weigh the risk and benefits of the behavior both as a society and as an individual based on unbiased information. Be warned though that a society without risk shall cease to exist. Let us be logical in our endeavors and true in our pursuit of knowledge. Instead of just waiting for lung cancer to get me (because the media and a lot of the medical literature told me that smoking causes lung cancer), I can enjoy my occasional cigar even more now...now that I know the whole story.

* * * * *

The Untold Facts of Smoking (Yes, there is bias in science)

or

"I feel like the Fox Network" (a bastion of truth in a sea of liberalism)

USWM smokers have a lifetime relative risk of dying from lung cancer of only 8 (not the 20 or more that is based on an annual death rate and therefore virtually useless).

No study has ever shown that casual cigar smoker (<5 cigars/wk, not inhaled) has an increased incidence of lung cancer.

Lung cancer is not in even in the top 5 causes of death, it is only #9.**

All cancers combined account for only 13% of all annual deaths and lung cancer only 2%.**

Occasional cigarette use (<1 pk/wk) has never been shown to be a risk factor in lung cancer.

Certain types of pollution are more dangerous than second hand smoke.3

Second hand smoke has never been shown to be a causative factor in lung cancer.

A WHO study did not show that passive (second hand) smoke statistically increased the risk of getting lung cancer.

No study has shown that second hand smoke exposure during childhood increases their risk of getting lung cancer.

In one study they couldn't even cause lung cancer in mice after exposing them to cigarette smoke for a long time.23

If everyone in the world stopped smoking 50 years ago, the premature death rate would still be well over 80% of what it is today.1 (But I thought that smoking was the major cause of preventable death...hmmm.)

*This article was revised with after errors in the data and calculations were noticed by Charles Rotter, Curtis Cameron and Jesse V. Silverman. This is the corrected version. A special thanks to both.

Nordlund LA, Trends in smoking habits and lung cancer in Sweden, Eur J Cancer Prev 1998 Apr;7(2):109-16 "Tobacco smoking is the most important cause of lung cancer and accounts for about 80-90% of all cases of lung cancer among men and about 50-80% among women."

JAMA 1997;278:1505-1508 "The chief cause of death included lung cancer, esophageal cancer and liver cancer. The death rate was higher for those who started smoking before age 25. If current smoking patterns persist, tobacco will eventually cause more than two million deaths each year in China."

JAMA 1997;278:1500-1504 "We have demonstrated that smoking is a major cause of death in China...."

Sarna L, Prevention: Tobacco control and cancer nursing, Cancer Nurs 1999 Feb;22(1):21-8 "In the next century, tobacco will become the number-one cause of preventable death throughout the world, resulting in half a billion deaths."

Nordlund LA Trends in smoking habits and lung cancer in Sweden. Eur J Cancer Prev 1998 Apr;7(2):109-16 "Tobacco smoking is the most important cause of lung cancer and accounts for about 80-90% of all cases of lung cancer among men and about 50-80% among women."

"Cigarette smoking, the chief preventable cause of illness and death in the industrialized nations"...

2. Websites:

JAMA website: "Yet huge obstacles remain in our path, and new roadblocks are being erected continuously," writes Ronald M. Davis, M.D., director of the Center for Health Promotion and Disease Prevention, Henry Ford Health System, Detroit, Mich., in urging a review of the effort against "the most important preventable cause of death in our society."

JAMA Website: "According to the authors, tobacco use has been cited as the chief avoidable cause of death in the U.S., responsible for more than 420,000 deaths annually ...."

JAMA Website: "The researchers reported that of deaths caused by tobacco...."

Reader Comments

"11. If everyone in the world stopped smoking 50 years ago, the premature death rate would still be well over 80% of what it is today.1 (But I thought that smoking was the major cause of preventable death...hmmm."

Which article is that from? I'm having trouble grasping that, what evidence is that based on?

Absolutely agree with the authors message. I have always thought that way.
Just cannot comprehend what the Fox News (I presume) Network has to do with this.
Do you mean: Fox News viewers are the least informed (http://www.forbes.com/sites/kenrapoza/2011/11/21/fox-news-viewers-uninformed-npr-listeners-not-poll-suggests/) but it does not prove absolute causality. Agree with that.

I noted the mention of asbestos and cancer. A study I heard of talked about a one hundred times increase in asbestos harm in smokers vs nonsmokers exposed to the same amount of asbestos. If the asbestos exposure was unknown or ignored this harm would be blamed exclusively on the smoking instead of the real culprit.
The same goes for radioactive fall out that collects on tobacco in the fields and is then inhaled directly into the lungs. This happened a lot during the years of atmospheric nuclear testing in America.
Avoiding liability for the cancerous results of this testing may have caused the sudden medical establishment decision to demonise tobaco.